Trandolapril in hypertension: overview of a new angiotensin-converting enzyme inhibitor.

Trandolapril is a new angiotensin-converting enzyme (ACE) inhibitor that has been extensively investigated in vitro, in animals, in normal volunteers, and in hypertensive patients. It has been shown to exert all the effects typical for the class of ACE inhibitors, and has a marked impact on the reversal of structural hypertrophy of the myocardium and the arterial wall. Trandolapril is a prodrug that must be hydrolyzed to its active metabolite, trandolaprilat. This latter compound exhibits a particularly high affinity for converting enzyme, which results in a slow dissociation and one of the longest durations of action of any converting enzyme inhibitor known so far. Trandolapril reduces blood pressure consistently throughout the 24-hour period following intake. Accordingly, trandolapril, more than any other drug of its class, can be considered a true, once-a-day antihypertensive drug.